DIFFERENT SIDES OF DOGMA

To the Editor:

The report on Dr. Sally Satel suggests that if she draws so much criticism
for her views on drug addiction, she must be saying something important.
Would that it were so ("A Critic Takes on Psychiatric Dogma, Loudly").

Dr. Satel argues that addiction is an entirely voluntary behavior while
Washington prefers the fiction that addiction is just a brain disease.
These polar extremes are both overly simplistic.

People taking mood-altering drugs for the first time do so voluntarily. But
control is progressively lost as addiction gradually takes over.

Dr. Satel's perspectives are inappropriate for an advanced country like the
United States. Worldwide, addiction is now accepted increasingly as a
chronic, complex condition, which unpredictably often improves and
sometimes relapses. Much has been learned about reducing the harm drugs
cause to individuals, their families and their communities.

The United States should pay more attention to its many outstanding
clinicians and researchers working within a public health and evidence
based framework.

Dr. Alex Wodak, Sydney, Australia